Volume 194 - Issue 1
Impact of adverse news media on prescriptions for osteoporosis: effect on fractures and mortality
Authors: Philip N Sambrook, Jiang S Chen, Judy M Simpson and Lyn M March
Med J Aust 2011; 194 (1): 51-52. || doi: 10.5694/j.1326-5377.2011.tb04154.x
Published online: 3 January 2011
Published online: 3 January 2011
In reply: Readers will probably deduce that Paul J Sambrook is no relation of Philip N Sambrook.
The Australian Broadcasting Corporation, which aired The 7:30 Report that Paul Sambrook and colleagues refer to, subsequently acknowledged in writing that there were a number of factual errors in the original program. Under these circumstances, a right of reply was entirely appropriate.
There is ongoing debate about the incidence of osteonecrosis of the jaw (ONJ), but as the modelling used in our study1 did not involve any assumptions about this, it is irrelevant to our findings. The studies by Lo et al2 and Mavrokkoki et al3 did not report incidence of ONJ — they reported prevalence. Moreover, one of the coauthors of the letter by Paul Sambrook et al (above) has published that the estimates by Mavrokkoki et al, being from a retrospective postal survey, must be viewed with caution.4 The Lo et al study was approved by an institutional review board of the United States Food and Drug Administration (FDA), not “funded and conducted” by the FDA, as Sambrook and colleagues state in their letter.
There have been numerous studies of the effects of vertebral fractures and osteoporosis on quality of life. The authors claim that ONJ causes greater interference to a patient’s life than osteoporosis or vertebral fractures, but cite no references to justify this bald assertion.
The US court case of Boles v Merck & Co5 was not an “independent study” (as implied in the last paragraph of the letter by Sambrook et al), but a legal proceeding that is being appealed. One of the coauthors of the letter was a paid expert for the plaintiff.
ONJ is a serious complication of bisphosphonate therapy in the small proportion of affected individuals. We agree that patients need to be informed of the risks of therapy, but they also need to be informed of the consequences of not taking therapy (ie, the benefits forgone) to make a really informed decision. Our article was intended to let patients understand what those consequences might be.
The courts are certainly not the place for informed debate. And the media should appreciate that unbalanced reporting can have significant consequences.
Competing interests
Philip Sambrook serves on the medical advisory boards of and has received speaker fees from Amgen, Merck Sharp & Dohme, Novartis, Sanofi-Aventis and Servier.
References
- Sambrook PN, Chen JS, Simpson JM, March LM. Impact of adverse news media on prescriptions for osteoporosis: effect on fractures and mortality. Med J Aust 2010; 193: 154-156. 0_CBBCBFFH
- Lo JC, O’Ryan FS, Gordon NP, et al. Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure. J Oral Maxillofac Surg 2010; 68: 243-253. 0_pgfId-2231247
- Mavrokkoki T, Cheng A, Stein B, Goss A. Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia. J Oral Maxillofac Surg 2007; 65: 415-423. 0_CBBHECFC
- Sambrook PN, Olver I, Goss A. Bisphosphonates and osteonecrosis of the jaw. Aust Fam Phys 2006; 35: 801-803. 0_CBBHEAIF
- Boles v Merck & Co. Case no. 06-CV-9455. In re Fosamax products liability litigation, MDL 1789, US District Court, Southern District of New York (Manhattan). 0_i1095850